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Delayed ultrasound in patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy

Authors


Correspondence: Dr JN Hendry, 365 Eagle Heights, Canmore, Alberta, T1W 3C9, Canada. Email:jwhendry@telusplanet.net

Abstract

Abstract

Objectives:

To determine if patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy who have a low clinical likelihood of ectopic pregnancy are put at risk of adverse events by delaying ultrasonography 12–18 h after emergency department presentation.

Methods:

A retrospective chart review of all surgically proven ectopic pregnancies at our Institution over a 2-year period.

Results:

One hundred and seventeen cases of ectopic pregnancy were reviewed. Thirty-seven cases met predetermined criteria of ‘clinical stability’ at first presentation. These patients waited a median 14 h for diagnostic ultrasound with 62% waiting more than 12 h. No adverse events occurred while waiting for this diagnostic study.

Conclusions:

Preliminary results suggest that pregnant patients with abdominal pain and vaginal bleeding in the first trimester who meet specific low-risk clinical criteria could potentially have ultrasound delayed 12–18 h without risk of adverse event. Further prospective studies are warranted to confirm the safety of this strategy.

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